City of Peoria
Sustainability & Water Conservation
Water Conservation Kit
Limit one per water account
Water Billing Account Number (XXXXX-X)
*
Name
*
First Name
Last Name
Address
*
Street Address
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred Library Pickup Location
*
Peoria Public Library (8463 W Monroe St, Peoria, AZ 85345)
Sunrise Mountain Library (21109 N 98th Ave, Peoria, AZ 85382)
Have you previously participated in a City of Peoria Sustainability & Water Conservation Program?
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Yes
No
How would you describe your current level of familiarity with water conservation practices?
*
Extremely Familiar
Moderately Familiar
Somewhat Familiar
Slightly Familiar
Not At All Familiar
How did you first hear about this program?
*
Please Select
Bill Insert (PeoriaNOW)
City Building (Library, etc.)
City Employee
City Event
City Mail (Sustain & Gain, etc.)
City Website
New Customer Email
Email/Newsletter
Family/Friends/Neighbor
HOA/Community Org
Internet Search
Landscaper/Contractor
News Outlet
Peoria School
Social Media
Store/Business
Choose the option that fits best.
I commit to installing the water efficient devices within a month of pickup.
*
PLEDGE TO SAVE WATER
Submit
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